Pharmacy Spread Check: Claims Against NADAC
A health plan's pharmacy claims against NADAC.
Open the tool → Runs in your browser. Data leaves only if you deliberately send a problem report from the interactive tool.
Example
- Claims, one per line
- 00002-1433-80, 2, 2020-01-15, 1000, 25, 950 00093-5056-98, 30, 2020-01-20, 9.99, 5, 8.50
Result: None of the 2 claims could be priced against NADAC, so there is no total.
The tool opens with these values already filled in. Replace them with your own.
What you enter
- Claims, one per line: NDC, quantity, fill date, plan paid, member paid, pharmacy paid (optional)
How this is calculated
Citation
CMS National Average Drug Acquisition Cost (NADAC) per unit on each fill date times quantity, against what the plan and member paid; the spread is what was paid less what the pharmacy received, where disclosed. Read the source ↗
A reference and educational tool. Not medical, legal, or financial advice, and not a substitute for clinician judgment.